Neonatal Atrial Flutter Approach: A Case Series

Authors

  • Fernanda Pessa Valente Instituto de Medicina Integral Professor Fernando Figueira – Recife (PE), Brazil.
  • Gustavo Henrique Belarmino Góes Universidade de Pernambuco – Faculdade de Ciências Médicas – Recife (PE), Brazil.
  • Caroline Bernardi Fabro Universidade de Pernambuco – Faculdade de Ciências Médicas – Recife (PE), Brazil.
  • Afonso Luiz Tavares Albuquerque Pronto Socorro Cardiológico de Pernambuco – Recife (PE), Brazil.
  • Dário Celestino Sobral Filho Universidade de Pernambuco – Faculdade de Ciências Médicas – Recife (PE), Brazil.

Keywords:

Cardiac arrhythmia, Supraventricular, Neonatal

Abstract

Objective: This study set out to analyze the therapeutic options of patients with neonatal atrial flutter (AFL), considering the diagnostic methods available and the prognosis of these patients. Methodology: A retrospective study was performed by reviewing the medical records of a series of seven patients with atrial fibrillation (AF) diagnosed during fetal or neonatal period. The follow-up time of these patients ranged from 7 months to 3 years and 8 months (mean: 1 year). The clinical data for the diagnosis included sustained heart rate greater than 180 bpm, which was confirmed in all patients by a 12-lead electrocardiogram. Results: Four (57.1%) of the 7 patients studied were male. Most of the patients revealed cardiac arrhythmia during the intrauterine period when screened by fetal ultrasound in the third trimester of gestation (5 patients, i.e. 71.2%). Only the mother of Patient 2 was administered digoxin before childbirth. The atrial rate of the tachyarrhythmia revealed a mean of 375 bpm, with an increase of up to 500 bpm. Atrioventricular conduction presented a 2:1 ratio in all patients, with variations of 3:1 and 4:1 observed in Patients 1, 3 and 6. The ventricular rate ranged from 188 to 250 bpm. All patients revealed typical and counter-clockwise electrocardiogram characteristics. Synchronized electrical cardioversion was the treatment of choice in 6 patients (85.7%), with a dose of 1 J/kg. Conclusion: Early diagnosis, prior treatment, and synchronized electrical cardioversion indicate an excellent prognosis, and prolonged maintenance treatment may be unnecessary.

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Published

2020-04-16

How to Cite

Valente, F. P. ., Góes, G. H. B. ., Fabro, C. B. ., Albuquerque, A. L. T. ., & Sobral Filho, D. C. . (2020). Neonatal Atrial Flutter Approach: A Case Series. JOURNAL OF CARDIAC ARRHYTHMIAS, 32(4), 245–251. Retrieved from https://jca.org.br/jca/article/view/3375

Issue

Vol. 32 No. 4 (2019)

Section

Clinical Arrythmia